The overall death rate from unintentional injury among children and teens fell by more than 25% from 2000 to 2009, a review of U.S. mortality data showed.

The overall death rate from unintentional injury among children and teens fell 29% from 2000 to 2009, a review of U.S. mortality data showed.

However, despite improvement in the overall rate, rates of death by poisoning in young adults -- mostly from prescription drug overdose -- and suffocation in infants rose, the CDC reported in the April 16 issue of Morbidity and Mortality Weekly Report.

And unintentional injury still accounted for 37% of all deaths in the 19-and-under age group in 2009 and was the fifth leading killer of patients younger than 1, the report said.

Data for the report were collected from the CDC's National Vital Statistics System, which included death certificate data from the 50 states and the District of Columbia. The study categorized the mechanisms for death by unintentional injury as drowning, fall, fires and burns, motor vehicle traffic-related, other transportation-related, poisoning, suffocation, and other.

For all age groups, the overall accidental death rate declined except in those less than a year old, where the rate increased from 23.1 to 27.7 deaths per 100,000 from 2000 to 2009.

The decline in the overall death rate was primarily the result of a drop in accidental motor vehicle-related deaths, which decreased overall by 41%, from 9.3 per 100,000 people in 2000 to 5.5 per 100,000 people in 2009. By subcategory, occupant and pedal cyclist deaths showed the largest decreases, by 47% and 52% respectively.

In patients under age 1, suffocation was the primary driver of the increased overall death rate -- rising by 54% from 13.8 to 21.3 per 100,000 over the 9-year period.

Although the overall death rate in patients ages 15 to 19 decreased over the study period by 33% (33.4 to 22.3 per 100,000), accidental poisoning deaths increased by 91% in patients ages 15 to 19 over the study period -- from 1.7 to 3.3 per 100,000.

In a conference call Monday, lead author Julie Gilchrist, MD, of the CDC's Division of Unintentional Injury Prevention, said that empowered parents and safer environments could help curb accidental child deaths in the U.S.

Gilchrist and co-authors noted that suffocation deaths in infants can be prevented by following safe sleep environment recommendations made by the American Academy of Pediatrics. Those recommendations include always positioning an infant on his or her back, using a firm sleep surface, room-sharing without bed-sharing, and avoiding loose bedding.

The increase in reported suffocation deaths also was partially caused by an improvement in differentiating between sudden infant death reports from accidental suffocations, Gilchrist said.

Gilchrist also noted that poisoning rates in young adults, mostly attributed to the abuse of opioid painkillers, mirror those found in adult patients. Drugs were made available at home, at friends' homes, through drug sharing, or through alternate illegal sales.

The researchers wrote that misuse of these prescription painkillers could be curbed through "appropriate prescribing, proper storage and disposal, discouraging medication sharing, and state-based prescription drug monitoring programs."

Despite the overall reductions in mortality for patients 19 and younger, the U.S. still has higher death rates compared with other developed countries for that same age group.

Out of the 34 Organization for Economic Cooperation and Development countries, the U.S. ranked 30th in patients 14 and younger in 2008, "with a [death] rate four times higher than the top-performing nations," the authors noted. In 2004 and among patients 19 and younger, the U.S. had nearly twice the combined accidental death rates of the high-income countries in the World Health Organization's European and Western Pacific Regions.

The report was limited by two factors: possible misclassification errors on death certificates and unintentional injury death reporting, the latter of which may not properly underscore the total burden of accidental injury on society.

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